Patterns of Antibacterial Therapy of Community-Acquired Pneumonia in Hospitalized Adults in Different Regions of Russia: Lessons from Multicentre Pharmacoepidemiology Study

Clinical Microbiology and Antimicrobial Chemotherapy. 2009; 11(1):66-78

Type
Journal article

Abstract

The aim of the study was to examine the patterns of systemic antibiotic (AB) use in adults with communityacquired pneumonia (CAP) in multi-word hospitals of different regions of Russia and assess the adherence of antibacterial therapy to the Russian national guidelines of CAP management. A total of 3798 clinical charts of patients with confirmed diagnosis of CAP (mean age 49,5±19,9 years old, 58% males, 29,5% – with severe pneumonia) in 29 multiward hospitals of 13 cities hospitalized in 2005–2006 were included into the study. Antibiotics were prescribed to 99,8% of patients. Cefotaxim, ampicillin and ceftriaxone were the most commonly used AB for non-severe CAP, ampicillin, cefotaxim and ceftriaxone – for severe cases (prescribed in 28,3, 21,2, 17,3 and 26%, 18,3%, 14,8% of cases, respectively). Combinations of AB as the first line therapy were given to 15,7% of patients with non-severe and 33,7% – with severe CAP. Prescribing of AB in accordance with the national guidelines was observed in 72,3% and 14,7% of patients; switching from IV to oral AB in compliance with the existing criteria – in 18% of patients, mean length of antibacterial therapy was 13,2±5,6 days. Quality of AB therapy in hospitalized adults with CAP varied significantly between sites. High rate of inadequate AB choice in case of severe CAP, low performance of step-down AB therapy and inaccurate use of AB combinations were the most critical problems.

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